Provider Demographics
NPI:1760082911
Name:ABDIKARIM, ELHAM A
Entity Type:Individual
Prefix:
First Name:ELHAM
Middle Name:A
Last Name:ABDIKARIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9217 17TH AVE S STE 214
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-2372
Mailing Address - Country:US
Mailing Address - Phone:952-228-3797
Mailing Address - Fax:
Practice Address - Street 1:9217 17TH AVE S STE 214
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55425-2372
Practice Address - Country:US
Practice Address - Phone:952-228-3797
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider